Celiac Axis and Common Hepatic Artery Variations in 5002 Patients: Systematic Analysis with Spiral CT and DSA
Celiac Axis and Common Hepatic Artery Variations in 5002 Patients: Systematic Analysis with Spiral CT and DSA
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DOI：
10.1148/radiol.09090389
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发表时间：
2010-04-01
期刊：
影响因子：
19.7
通讯作者：
Park, Jae Hyung
中科院分区：
文献类型：
--
作者：
Song, Soon-Young;Chung, Jin Wook;Park, Jae Hyung
目的：应用螺旋CT（CT）和数字减影血管造影（DSA）技术对腹腔动脉（CA）和肝总动脉（CHA）变异进行诊断和评价。回顾性分析5002例患者的螺旋CT和DSA表现。CHA定义为包含至少一个节段性肝动脉和胃十二指肠动脉的动脉干。分析CA和上级肠系膜动脉分支的主动脉起源模式。结果：在15种可能的CA变异类型中，确定了13种变异类型。在5002例患者中，4457例（89.1%）CA正常。482例（9.64%）患者中发现12种CA变异。在其余63例（1.26%）患者中，由于肝动脉和胃十二指肠动脉（n = 55）的单独起源或由于持续吻合通道（n = 8）而无法确定CHA的起源，CA解剖结构被归类为不明确。7例起源于正常CA的CHA有门静脉后（n = 6）或经胰腺（n = 1）病程。所有8例起源于胃左动脉的CHA均通过静脉韧带裂。起源于上级肠系膜动脉的148例CHAs显示出与胰腺的不同关系--胰腺上、跨或胰腺下--以及上级肠系膜-门静脉轴--门静脉前或门静脉后。20例起源于主动脉的CA均具有正常的胰上门脉前走行。结论：对已知或新发现的CA和CHA变异可进行系统详细的描述。作者提出了一个假设的解剖模型来总结观察到的CHA变化。(C)RSNA，2010年
Purpose:To identify and evaluate the spectrum and prevalence of celiac axis (CA) and common hepatic artery (CHA) variations by using spiral computed tomography (CT) and digital subtraction angiography (DSA).Materials and Methods:Institutional review board approval was obtained, and the requirement for informed patient consent was waived. The findings in 5002 patients who underwent spiral CT and DSA were retrospectively evaluated. CHA was defined as an arterial trunk containing at least one segmental hepatic artery and the gastroduodenal artery. The pattern of the aortic origin of the branches of the CA and superior mesenteric arteries was analyzed. The CHA anatomy was then investigated.Results:Of 15 possible types of CA variation, 13 types were identified. A normal CA was noted in 4457 (89.1%) of the 5002 patients. Twelve types of CA variation were identified in 482 (9.64%) patients. In the remaining 63 (1.26%) patients, the CA anatomy was classified as ambiguous because the CHA was absent owing to separate origins of the hepatic arteries and the gastroduodenal artery (n = 55) or because the origin of the CHA could not be determined owing to persistent anastomotic channels (n = 8). Seven CHAs originating from the normal CA had a retroportal (n = 6) or transpancreatic (n = 1) course. All eight CHAs originating from the left gastric artery passed the fissure of the ligamentum venosum. The 148 CHAs originating from the superior mesenteric artery showed diverse relationships with the pancreas-being supra-, trans-, or infrapancreatic-and the superior mesenteric-portal venous axis-being pre-or retroportal. The 20 CHAs originating from the aorta had a normal suprapancreatic preportal course.Conclusion:Known or newly found CA and CHA variations could be systematically described in detail. The authors propose a hypothetical anatomic model for summarizing the observed CHA variations. (C) RSNA, 2010